The short-term effects of head-mounted virtual-reality on neuropathic pain intensity in people with spinal cord injury pain: a randomised cross-over pilot study

Spinal Cord ◽  
2020 ◽  
Author(s):  
Philip D. Austin ◽  
Ashley Craig ◽  
James W. Middleton ◽  
Yvonne Tran ◽  
Daniel S. J. Costa ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Virtual Reality ◽  
Neuropathic Pain ◽  
Pilot Study ◽  
Pain Intensity ◽  
Short Term ◽  
Cord Injury ◽  
Spinal Cord Injury Pain ◽  
Short Term Effects

scholarly journals The effects of FES cycling combined with virtual reality racing biofeedback on voluntary function after incomplete SCI: a pilot study

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Lynsey D. Duffell ◽  
Sue Paddison ◽  
Ahmad F. Alahmary ◽  
Nick Donaldson ◽  
Jane Burridge
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Virtual Reality ◽  
Electrical Stimulation ◽  
Pilot Study ◽  
Controlled Trial ◽  
Training Programme ◽  
International Standards ◽  
Motor Score ◽  
Cord Injury

Abstract Background Functional Electrical Stimulation (FES) cycling can benefit health and may lead to neuroplastic changes following incomplete spinal cord injury (SCI). Our theory is that greater neurological recovery occurs when electrical stimulation of peripheral nerves is combined with voluntary effort. In this pilot study, we investigated the effects of a one-month training programme using a novel device, the iCycle, in which voluntary effort is encouraged by virtual reality biofeedback during FES cycling. Methods Eleven participants (C1-T12) with incomplete SCI (5 sub-acute; 6 chronic) were recruited and completed 12-sessions of iCycle training. Function was assessed before and after training using the bilateral International Standards for Neurological Classification of SCI (ISNC-SCI) motor score, Oxford power grading, Modified Ashworth Score, Spinal Cord Independence Measure, the Walking Index for Spinal Cord Injury and 10 m-walk test. Power output (PO) was measured during all training sessions. Results Two of the 6 participants with chronic injuries, and 4 of the 5 participants with sub-acute injuries, showed improvements in ISNC-SCI motor score > 8 points. Median (IQR) improvements were 3.5 (6.8) points for participants with a chronic SCI, and 8.0 (6.0) points for those with sub-acute SCI. Improvements were unrelated to other measured variables (age, time since injury, baseline ISNC-SCI motor score, baseline voluntary PO, time spent training and stimulation amplitude; p > 0.05 for all variables). Five out of 11 participants showed moderate improvements in voluntary cycling PO, which did not correlate with changes in ISNC-SCI motor score. Improvement in PO during cycling was positively correlated with baseline voluntary PO (R2 = 0.50; p < 0.05), but was unrelated to all other variables (p > 0.05). The iCycle was not suitable for participants who were too weak to generate a detectable voluntary torque or whose effort resulted in a negative torque. Conclusions Improved ISNC-SCI motor scores in chronic participants may be attributable to the iCycle training. In sub-acute participants, early spontaneous recovery and changes due to iCycle training could not be distinguished. The iCycle is an innovative progression from existing FES cycling systems, and positive results should be verified in an adequately powered controlled trial. Trial registration ClinicalTrials.gov, NCT03834324. Registered 06 February 2019 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03834324. Protocol V03, dated 06.08.2015.

scholarly journals Virtual reality improves embodiment and neuropathic pain caused by spinal cord injury

Neurology ◽  
2017 ◽  
Vol 89 (18) ◽  
pp. 1894-1903 ◽  
Author(s):  
Polona Pozeg ◽  
Estelle Palluel ◽  
Roberta Ronchi ◽  
Marco Solcà ◽  
Abdul-Wahab Al-Khodairy ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Virtual Reality ◽  
Neuropathic Pain ◽  
Repeated Measures ◽  
Visual Analogue Scale Pain ◽  
Body Ownership ◽  
Repeated Measures Design ◽  
Head Mounted Display ◽  
Cord Injury

Objective:To investigate changes in body ownership and chronic neuropathic pain in patients with spinal cord injury (SCI) using multisensory own body illusions and virtual reality (VR).Methods:Twenty patients with SCI with paraplegia and 20 healthy control participants (HC) participated in 2 factorial, randomized, repeated-measures design studies. In the virtual leg illusion (VLI), we applied asynchronous or synchronous visuotactile stimulation to the participant's back (either immediately above the lesion level or at the shoulder) and to the virtual legs as seen on a VR head-mounted display. We tested the effect of the VLI on the sense of leg ownership (questionnaires) and on perceived neuropathic pain (visual analogue scale pain ratings). We compared illusory leg ownership with illusory global body ownership (induced in the full body illusion [FBI]), by applying asynchronous or synchronous visuotactile stimulation to the participant's back and the back of a virtual body as seen on a head-mounted display.Results:Our data show that patients with SCI are less sensitive to multisensory stimulations inducing illusory leg ownership (as compared to HC) and that leg ownership decreased with time since SCI. In contrast, we found no differences between groups in global body ownership as tested in the FBI. VLI and FBI were both associated with mild analgesia that was only during the VLI specific for synchronous visuotactile stimulation and the lower back position.Conclusions:The present findings show that VR exposure using multisensory stimulation differently affected leg vs body ownership, and is associated with mild analgesia with potential for SCI neurorehabilitation protocols.

Poster 20 Preliminary Validation of the Spinal Cord Injury Pain Instrument (SCIPI), a Neuropathic Pain Screening tool

2013 ◽  
Vol 94 (10) ◽  
pp. e19
Author(s):  
Thomas Bryce ◽  
J Scott Richards ◽  
Marcel PJM. Dijkers ◽  
Larry Brooks ◽  
Jesse R. Fann ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neuropathic Pain ◽  
Screening Tool ◽  
Preliminary Validation ◽  
Cord Injury ◽  
Spinal Cord Injury Pain

Neuropathic pain following spinal cord injury pain: mechanisms and treatment

2009 ◽  
Vol 1 ◽  
pp. S3-S11 ◽  
Author(s):  
Nanna Brix Finnerup ◽  
Cathrine Baastrup ◽  
Troels Staehelin Jensen
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neuropathic Pain ◽  
Pain Mechanisms ◽  
Cord Injury ◽  
Spinal Cord Injury Pain

scholarly journals Screening for neuropathic pain after spinal cord injury with the Spinal Cord Injury Pain Instrument (SCIPI): a preliminary validation study

Spinal Cord ◽  
2014 ◽  
Vol 52 (5) ◽  
pp. 407-412 ◽  
Author(s):  
T N Bryce ◽  
J S Richards ◽  
C H Bombardier ◽  
M P Dijkers ◽  
J R Fann ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neuropathic Pain ◽  
Validation Study ◽  
Preliminary Validation ◽  
Cord Injury ◽  
Spinal Cord Injury Pain

scholarly journals Tissue bridges predict neuropathic pain emergence after spinal cord injury

2020 ◽  
Vol 91 (10) ◽  
pp. 1111-1117
Author(s):  
Dario Pfyffer ◽  
Kevin Vallotton ◽  
Armin Curt ◽  
Patrick Freund
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neuropathic Pain ◽  
Pain Intensity ◽  
Conditional Inference ◽  
Spinal Cord Tissue ◽  
Spinothalamic Tract ◽  
Cord Injury ◽  
Pain Outcomes ◽  
Neuroimaging Data

ObjectiveTo assess associations between preserved spinal cord tissue quantified by the width of ventral and dorsal tissue bridges and neuropathic pain development after spinal cord injury.MethodsThis retrospective longitudinal study includes 44 patients (35 men; mean (SD) age, 50.05 (18.88) years) with subacute (ie, 1 month) spinal cord injury (25 patients with neuropathic pain, 19 pain-free patients) and neuroimaging data who had a follow-up clinical assessment at 12 months. Widths of tissue bridges were calculated from midsagittal T2-weighted images and compared across groups. Regression analyses were used to identify relationships between these neuroimaging measures and previously assessed pain intensity and pin-prick score.ResultsPin-prick score of the 25 patients with neuropathic pain increased from 1 to 12 months (Δmean=10.08, 95% CI 2.66 to 17.50, p=0.010), while it stayed similar in pain-free patients (Δmean=2.74, 95% CI −7.36 to 12.84, p=0.576). They also had larger ventral tissue bridges (Δmedian=0.80, 95% CI 0.20 to 1.71, p=0.008) at 1 month when compared with pain-free patients. Conditional inference tree analysis revealed that ventral tissue bridges’ width (≤2.1 or >2.1 mm) at 1 month is the strongest predictor for 12 months neuropathic pain intensity (1.90±2.26 and 3.83±1.19, p=0.042) and 12 months pin-prick score (63.84±28.26 and 92.67±19.43, p=0.025).InterpretationLarger width of ventral tissue bridges—a proxy for spinothalamic tract function—at 1 month post-spinal cord injury is associated with the emergence and maintenance of neuropathic pain and increased pin-prick sensation. Spared ventral tissue bridges could serve as neuroimaging biomarkers of neuropathic pain and might be used for prediction and monitoring of pain outcomes and stratification of patients in interventional trials.

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